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Care system forced to agree new governance after council quits

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  • Luton Council quit ICS over concerns process is “pre-determined” and “disempowered” local decisions
  • New agreement between council and ICS means council leader will no longer be member of the leaders group

Health leaders in one of the first wave of “integrated care systems” have been forced to agree new ad hoc ways of working with a council, after it formally quit the partnership, it has emerged.



Luton BC has pulled out of the Bedfordshire, Luton and Milton Keynes ICS over concerns it had little influence over the plans, Health Service Journal reports.

In a letter to its partners, seen by HSJ, the council said “it does not wish to be considered a signatory to any sustainability and transformation partnership process or bodies”.

It said the ICS governance process was “somewhat pre-determined” and “disempowered” local decisions. The Labour-led council also said it “politically opposed” the plans.

The ICS leaders have since had to implement a new working arrangement with the council which recognises its formal exclusion.

BLMK was one of the first eight health economies originally announced as an ICS by Simon Stevens in June 2017.

Last summer, three out of the four councils involved in the ICS threatened to quit over concerns local government opinions were being “overlooked”.

Luton is the only one of the four to so far act on this threat, having told partners that it was pulling out in November. A spokesman told HSJ the other three remained involved.

As a result of Luton’s withdrawal, Richard Carr, BLMK ICS leader and Central Bedfordshire Council chief executive, has agreed a new way of working with the council to allow it to be involved with the ICS on an ad hoc basis.

The new agreement, shared with HSJ in response to questions, said “the ICS will never represent Luton council as a party to an agreement (eg ICS five year plan)” and the leader of the council, Hazel Simmons, “will no longer be a member of the ICS leaders and chairs group nor receive agenda and papers”.

A spokesman for the council told HSJ the new agreement “ensures that decisions which relate to the people of Luton are taken through the proper governance arrangements at Luton Council, as we were concerned that ICS arrangements did not ensure that this happened”.

He added: “[The council] does not currently have plans to review this new arrangement.”

The council already has close working relationships with Luton Clinical Commissioning Group and said this would continue under the new arrangements.

In November, Nottingham City Council, also a Labour council, suspended its involvement in the Nottinghamshire ICS due to a “lack of democratic oversight”.

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